The candidate's research program in psychoneuroimmunology (PNI) has focused on psychological influences on immune function in humans. Older adults represent a particularly important population for PNI research. Immune function declines with age, particularly functional aspects of the cellular immune response, and these-age-related decrements are thought to be associated with the greatly increased morbidity and mortality from infectious in the elderly. Furthermore, older adults show greater immunologic impairments related to depression or stress than younger adults. Two recent studies from the candidate's lab have confirmed that chronic stress has clear adverse consequences for older adults' physical health: caregivers for a spouse with a progressive dementia demonstrated slower wound healing and impaired influenza vaccine response when compared to well-matched controls. These data are very relevant to a central question throughout the PNI literature, the extent to which stress-induced immunologic changes have measurable consequences for morbidity and mortality. Chronic stress is likely to have additional ramifications for infectious illness beyond vulnerability to influenza. Immune responses to influenza vaccine reflect (primarily) immunologic memory. However, age-related decrements in immune function are most pronounced for "new" antigents, i.e., primary immune responses; therefore, the influenza vaccine data may actually underestimate the impact of stress on antigen processing. The addition of two new vaccines to the longitudinal study will provide information directly relevant to this issue. By assessing immune responses to hepatitis A and pneumococcal pneumonia vaccines (as well as continued studies on influenza vaccine), the study will provide further data on stress-related alterations in both primary and memory immune responses of direct relevance to older adults' health. In addition, further pilot studies related to stress and wound healing are proposed. Thus, the candidate's research efforts will be directed toward enhancing the understanding of the actual health consequences of stress-related immunologic changes among older adults.